DOI

Document Type

Date of Degree

Degree Name

Degree In

First Advisor

Elizabeth Altmaier

First Committee Member

Carolyn Turvey

Second Committee Member

John Westefeld

Third Committee Member

Timothy Ansley

Fourth Committee Member

Howard Butcher

Abstract

The American older adult population is rapidly growing and projected to double by 2030. There is high proportion of completed suicides in later life subsequent to several biopsychosocial variables. Medical populations, particularly Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure (HF), have greater risk of depression, suicidality, and lower quality of life. Current geropsychology suicide research tends to focus on risk factors, a deficit approach. In contrast, the present study utilized a strength-based approach to study late life suicide by predicting life sustaining cognitions, reasons for living (RFL). This study explored the influence of physical health related quality of life (HRQOL) and depression on RFL in a sample of 75 depressed and chronically ill middle aged and older adults enrolled in a randomized clinical trial. The results indicate insignificant relationships between demographic variables (e.g. age, gender, and illness type) and reasons for living. Despite the statistically significant negative correlations between depression and physical and mental HRQOL at baseline and week five, only week five depression significantly predicted RFL (Β = -1.369, ΔR2 = .063, p= .034), after the effects of age and baseline depression were held constant. In conclusion, the present study supports integrative primary care modalities of treatment for late life depression and highlights the importance of incorporating protective factors in suicide risk assessments. Future research should consider utilizing population specific instruments and alternative medical and social variables.

Public Abstract

Late life suicide is a growing issue secondary to the high proportion of completed suicides in later life and projected increase in the American older adult population. Current late life suicide research focuses on suicide risk factors, a deficit approach. In contrast, the present study aims to explore suicide protective factors through reasons for living, a strength-based construct pertaining to cognitive deterrents to considering suicide as an option.

This study is exploratory in nature and sought to predict reasons for living among depressed and chronically ill (chronic obstructive pulmonary disease and heart failure) middle aged and older adults (55 years and older) enrolled in five weeks of a randomized clinical trial.

Depression significantly predicted reasons for living; week five depression severity accounted for reasons for living (β = -1.369, ΔR2 = .063, p= .034), after the effects of age and baseline depression severity were held constant. Conversely, physical health related quality of life did not predict reasons or living; however, depression and health related quality of life were significantly correlated at both time points (baseline and week five). Based on this study’s findings, clinical intervention should target depression; reduction in depression severity may serve to protect against late life suicide.